Richmond (VA) Ambulance Authority and FirstWatch Celebrate 12 Years Together

Date: 2014-10-24

Industry leader in public safety data, FirstWatch® announced the 12th anniversary of the company’s founding by Todd Stout, winner of the 2014 Pinnacle EMS Leadership Award and national recognized expert in public safety data.

Celebrating this milestone with FirstWatch is the Richmond Ambulance Authority (RAA). Twelve years ago RAA became the first EMS agency in the world to implement the commercial version of the FirstWatch biosurveillance system. Coming on the heels of 9/11, it monitored 9-1-1 data for unusual trends to provide early warning for bioterrorist or chemical attacks. Jerry Overton, RAA’s executive director at the time, said FirstWatch would be “a significant step in increasing our overall preparedness in these changing times.” RAA has since been at the forefront of change in the EMS profession and continues to use FirstWatch in innovative ways to improve their system’s operations and performance by way of data.

RAA was first established in 1991 under the Richmond Ambulance Authority Act in order to provide a unified provision of EMS services for the city of Richmond as a self-operated, stand-alone public utility model. Covering 62 square miles, the ambulance service responds to a resting population of 204,000 (which increases considerably by day) over 55,000 times per year. With a staff of around 260, RAA operates up to 27 vehicles at peak hours. Although it has one of the highest call volumes per capita in the United States, RAA has gained a national and international reputation as a premiere, high performing EMS system.

Operating on the principles of a high performance public utility model, RAA was founded on patient-centric ideas as taught by Jack Stout, the father of high-performance EMS and FirstWatch founder Todd Stout, Jay Fitch, founder of Fitch & Associates and Jerry Overton, now chair of the International Academies of Emergency Dispatch (IAED). To date, RAA is one of only 22 systems in the US that has received accreditation from both the National Commission on Accreditation of Ambulance Services (CAAS) and IAED. RAA is also a Commonwealth of Virginia accredited dispatch center.

RAA’s Communications Center [pictured, right] utilizes the TriTech CAD software VisiCAD Command for its dispatching system; Emergency Medical Priority Dispatching protocols are provided by ProQA. The Communication Center is operated on a system of flexible deployment referred to as System Status Management: the call volume data (by hour-of-day, day-of-week) is analyzed to determine the best placement of available unit deployment. A flexible staffing system is utilized in the Communications Center with as many as five dispatchers at some hours, to only two when the call volume is slow.

To gain perspective on how far RAA has come as both an agency and a FirstWatch customer over the past 12 years, RAA Chief Operating Officer Rob Lawrence shares his views.

Q: RAA originally implemented FirstWatch for early detection and alerting, in the wake of 9-11. How is RAA using FirstWatch today?

A: We are using FirstWatch today in every which way we can. From its original purpose, we are using the geosurvelliance and biosurveillance aspect of it to identify clusters of concerning activity and syndromic activity; we have added the Richmond City Health District views and alerts to this data set as well. While we’re still using FirstWatch in this classic sense, we are also now able to use the system to conduct off fraction reviews, provide real-time situational awareness during natural disasters, and enhance operational performance. In the past we have even used FirstWatch to measure long hospital drop times or to spot influenza trends.

Our decision to implement the ePCR reading version of FirstWatch means we take the Paramedic’s view of what is happening on the street. With our most recent purchase of the new QA/QI FirstPass® system, we’re able to focus our attention on the most important calls as they happen. This in turn points us to where we need to further train and educate our staff. Traditional quality improvement looks at a percentage of your call volume, FirstPass looks at everything – all the time. Everyone talks about how quickly we respond; now we can talk about with immediacy how well we’re performing clinically and we’re very excited about that.

Q: In most recent years you have been honored for your safety and early prevention programs. How did RAA get into this area and what can you tell us about its success?

A: We believe in the theory that Public Health is an equal part of EMS. If we can prevent an accident from happening before we have to attend to it then we don’t have to cure it. We are constantly looking at what makes up those frequent calls for deployment purposes, what are those conditions, and how can we affect some of those conditions to prevent traffic accidents from happening. When we start looking into our data, we can focus on areas in which these types of accidents are occuring most frequently and provide knowledge and awareness to our city – and the nation.

Q: How important is data to running an ambulance service?

A: Data is everything. It is indeed our favorite four letter word…many organizations don’t believe they have as much data as they really do. At RAA we believe we use data to save lives - it is absolutely imperative to us. With the FirstWatch system and those we have developed in house, we pull multiple data sources together to have a more intelligent view of our system as a whole.

Q: What does the future hold for RAA?

A: We’re looking forward to new models for the delivery of healthcare like Community Paramedicine. FirstWatch is currently helping us look at some aspects of this right now like alerting us to frequent users; however we look forward to exploring this deeper.